Impairments and Compensations of Static Balance and Plantar Load Distribution in Patients With Chronic Stroke: An...

The purpose of this study was to explore impairment and compensation characteristics of static balance and plantar load distribution in patients with chronic stroke.

We recruited 68 patients who had chronic stroke who could stand independently (stroke group) and 30 healthy individuals (control group) with the Zebris FDM platform. Static balance parameters, including center of pressure (COP) ellipse sway area, COP path length, and angle-θ between y and major axis, were compared between 2 groups under standard standing posture. In the stroke group, balance parameters were re-tested under their preferring standing posture. Plantar load distribution was also assessed. Another 8 patients with chronic stroke who could not stand independently and had to rely on a crutch were enrolled to analyze the characteristics of balance compensation.

In the stroke group, the ellipse sway area, COP path length, and angle-θ were significantly larger than those of the control group. Sixty-one (89.7%) patients preferred standing with the affected foot outward-forward supporting, and their preferring standing balance was better than that of standard standing. All patients who could not stand independently tended to compensate for balance with a crutch supporting laterally and also preferred standing with a typical posture- the affected foot was outward-forward.

In patients post stroke, static balance is impaired mainly at the lateral direction, and patients commonly locate the crutch laterally for compensation of lateral balance. Patients preferred standing with the affected foot outward-forward supporting, and their preferring standing balance was better than that of standard standing, which challenged the necessity of training standing symmetrically.